Asthma as a risk factor for zoster in adults: A population-based case-control study

J Allergy Clin Immunol. 2016 May;137(5):1406-12. doi: 10.1016/j.jaci.2015.10.032. Epub 2015 Dec 28.

Abstract

Background: We recently reported an increased risk of herpes zoster (shingles or zoster) in children with asthma, but little is known about whether the same is true for adults with asthma.

Objective: We determined whether asthma is associated with an increased risk of zoster in adults.

Methods: This study was designed as a population-based case-control study. Zoster cases during the study period were identified among adults (aged ≥50 years) who resided in Olmsted County, Minnesota. We compared the frequency of asthma between zoster cases and birthday- and sex-matched control subjects (1:2 matching) without a history of zoster. Asthma status was ascertained based on predetermined criteria. A conditional logistic regression model was used to assess the association of asthma with risk of zoster.

Results: A total of 371 zoster cases and their 742 matched control subjects were enrolled. Of the 371 cases, 246 (66%) were female, 348 (94%) were white, and the mean ± SD age was 66.8 ± 10.7 years. Twenty-three percent (n = 87) of zoster cases had a history of asthma compared with 15% (n = 114) of control subjects. Controlling for pertinent covariates and confounders, there was a significant association between a history of asthma and risk of zoster (adjusted odds ratio, 1.70; 95% CI, 1.20-2.42; P = .003). The population attributable risk percentage for asthma was about 10%.

Conclusions: Asthma is an unrecognized risk factor for zoster in adults. Consideration should be given to immunizing adults with asthma aged more than 50 years as a target group.

Keywords: Asthma; adults; epidemiology; herpes zoster; risk.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asthma / epidemiology*
  • Case-Control Studies
  • Female
  • Herpes Zoster / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Odds Ratio
  • Risk Factors